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Tampons and Toxic Shock Syndrome

M. T. Osterholm, PhD, MPH; J. P. Davis, MD; J. S. Mandel, PhD; R. W. Gibson, PhD; F. A. Wintermeyer, MD
JAMA. 1983;249(8):1004-1005. doi:10.1001/jama.1983.03330320012009.
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To the Editor.—  The recent article in The Journal (1982;247:835) by the Centers for Disease Control (CDC), Atlanta, regarding their second toxic shock syndrome (TSS) case-control study also discussed the results of our Tri-State Toxic Shock Syndrome Study (TSTSSS).1 We believe some of their study findings and ours have been misinterpreted in the CDC article.In the CDC report, emphasis was placed on the finding of the association of menstrually related TSS with the use of Rely brand tampons and the lack of difference found between cases and controls in the absorbency of the tampon product used. The discussion regarding the lack of a relationship between absorbency and the risk of TSS developing is incomplete and misleading. First, every tampon brand has two to five different brand styles (regular, super, and super plus) that have different absorbency levels. In September 1980, all five major tampon brands included brand styles


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